VA-DoD hospital governance issues may impede future joint efforts

Difficulties the departments of Veterans Affairs and Defense face when it comes to governance of the James A. Lovell Federal Health Care Center (FHCC) may impede future collaboration, according to a report from the Government Accountability Office.

The FHCC, based in North Chicago, was created in 2010 as the first medical center to be operated by both the VA and DoD (Navy) as a model for joint delivery of healthcare across both agencies. However, as the report shows, the collaboration has not necessarily been a smooth one.

Issues noted in the report include lack of FHCC-specific criteria to choose a director from the VA and deputy director from the Navy, difficulties with its IT infrastructure, including access to electronic health records, and a failure to conduct "comprehensive, data-driven staffing analyses" to manage workers across the facility.

The GAO makes eight recommendations in the report, to which the DoD and VA concurred. Some of them include:

Ensure evaluation of leadership performance is carried out jointly between the two agencies

Fix issues with IT network security before implementing any new integration efforts

Perform data-driven strategic workforce planning

Figure out the best way to fill short-term staffing needs

In its response to the report, the VA said it is working to complete FHCC-specific criteria for the director positions by July. In addition, a "Trusted Internet Gateway" for secure connections was completed in the first quarter of last year and both agencies are working toward a "common network security baseline."

For its part, the DoD simply concurred with all of the recommendations, adding that it will include a revised selection process for VA director and DoD deputy director roles in its next report to Congress.

A report from the Institute of Medicine in July 2012 found that lack of electronic health record interoperability at the FHCC adversely affected clinical care and cost the government millions of dollars. Interoperability between the two agencies continues to be a barrier to effective care.

While both agencies have pledged to comply with the GAO's recommendations, it still remains to be seen if the FHCC is a success.